31 January 2014

O’Neill government’s drug supply saga just won’t go away

BARBARA SHORT

IT ALL BEGAN BACK IN SEPTEMBER last year when Papua New Guinea prime minister Peter O’Neill announced that the Borneo Pacific Pharmaceutical company (BPP), owned by Malaysian interests, would be given a contract to supply PNG pharmaceuticals.

Australian foreign minister Julie Bishop then announced that her government would not support this decision as BPP did not have the ISO 9001 quality rating and this implied their procurement methods were not up to a standard where they could be trusted to maintain a supply of good quality drugs.

There had been a history of trouble in the supply of medical kits and Australia had come to PNG’s aid and contributed millions of kina to aid their distribution. But the BPP decision was a bridge too far for Ms Bishop.

It also seems to have had the same effect on many Papua New Guineans. There have been many people commenting in social media in PNG and many have contributed articles on the medical kits supply saga.

Over the last five months I have been following comments on the Facebook group, PNG News, set up by Charlie Gilichibi, which has over 65,000 members.

So far there have been 308 comments on this topic: by PNG public servants, health department officials, pharmaceutical professionals, doctors and concerned citizens. People educated enough to know that there is a problem and willing to try to do something to solve it.

One person has supplied me with a copy of the Good Procurement Manual published by the PNG Central Supply and Tenders Board (CSTB) to help government departments get value for money from their contracts.

It was CSTB that recommended that the National Executive Council award the contract to BPP. Prime MinisterPeter O’Neill later referred to the “rigorous tendering process”.

For a long time now, I have realised that many of the corruption allegations in PNG go back to problems with tenders, where corrupt individuals can get away with stealing millions of kina of government money. Some of the PNG News contributors are very suspicious of CSTB and feel it is open to bribery.

Two of PNG’s leading medical experts disclosed how there were two other companies that had tendered. Their prices were lower than BPP and they were also quality assured.

So it appeared that BPP had somehow got an inside run from the PNG government, the Health Department or CSTB.

PNG doctors have united to ask the government to reconsider the decision to award the contract to BPP and written to Mr O’Neill, but so far he has not replied.

Next Monday, the Community Coalition Against Corruption (CCAC) is holding an open forum on this topic in Port Moresby from 10am -12 noon. It’s for health workers and medical professionals and is being held in the New Lecture Theatre at the School of Medicine and Health Sciences, Taurama. The forum is supported by Transparency International and the Media Council of PNG.

In addition, some members of PNG News are planning to approach the PNG Independent Consumer and Competition Commission (ICCC) who work to protect consumer interests but have clearly not been asked to take part in any of the discussion on Borneo Pacific Pharmaceuticals.

One correspondent wrote recently –

We (PNG) don’t quite appreciate democracy and its privileges as yet, as maybe other countries who have gone through civil war and blood shed.

We are in a better scenario, for the nation to appreciate sovereignty and democracy through the issues we are experiencing today.

Too many people hold pretentious views by comparing us with other countries and developing high expectations without acknowledging the reality that 70% are illiterate and we lack the industries that are key to enable us.

We have been given our independence on a golden plate, we must go through our trials and tribulations like everybody else, its nature. That is where we are.

As a former teacher of many of today’s educated leaders in PNG, I will continue to support them as they struggle to come to grips with how to run the country in a thoughtful, compassionate and just way without bribery and corruption.

"Today the Community Coalition Against Corruption hosted a forum at the School of Medicine and Health Science (Medfac) to discuss the awarding of a K71 million contract to Borneo Pacific Pharmaceutical despite the company not meeting international certification standards (ISO 9002).

"Professor Glen Mola from the Papua New Guinea Medical Society talked about how the goal post was changed in the tendering process in order to allow Borneo Pharmaceuticals to qualify for the tender.

"Initially, ISO certification was a mandatory requirement however that was dropped during an extension of the time for bidding. ISO certification ensures that medical supplies are procured from reliable sources and supplied safely to health facilities.

"Meanwhile the Secretary of the National Doctors Association, Dr Sam Yokopua has threatened industrial action if the issue is not resolved satisfactorily. Dr Yokopua labelled the awarding of the contract by the O’Neill Government as “Pharmaceutical Genocide.”

"Members of the medical profession and pharmaceutical company representatives present during the meeting called for a bigger public forum to be organized at a later date.

"Despite much public awareness about today’s forum, the mainstream media was noticeably absent."

All of us on this topic will go and get ourselves proper medicines when we need to because we know the importance of real medicine and can afford it.

Many elected officials will probably go to Cairns, Singapore or John Hopkins for their medicines.

What of the rest, who don't understand side effects or no effects of fake medicine, who cannot afford one single pill and rely on what the government hands out?

There are bodies paid to inform the government and educate the citizens. I know about NISIT, there is ICCC, then the principal advisor to the CSTB who will have been talking together with doctors...

We are getting into this mess because someone is not doing his/her job.

You're where you are to serve your country. It's time now to do your work right and earn your good night's sleep knowing you've done your job to God and to your fellow citizen to the best of your ability independent of any fear or favour to anyone.

Minister for Health Michael Malabag has written about himself on his Facebook site -

"I was fortunate to be given a Scholarship back in 1974 to continue my education but I had to work as I had to support my single mother and my 9 brothers and sisters.

"I have served this Nation since 1975 when I was first employed by the GPO and then transferred to Electoral Commission in 1976.

"I made my way up to the level of Director Election Operations and on occasions acted as Deputy Electoral Commissioner.

"I was in the Union Movement for 26 years out of which I was President of PEA and PNGTUC for 10 years as from 2002.

"As a result I received 5 Awards from 5 different Governor Generals including an OBE.

"The point I am trying to make is that people love to criticize through the social media which I accept, but sometimes they go too far.

"I will remove myself from Sharp Talk and other groups as I am fed up with some of the comments attributed to me over the Borneo issue.

"I will however maintain my page to communicate with my Facebook friends as it is important that we MP's keep in touch with our people.

"The people will judge our performance and not a few elite minority on the social media.

"I will continue to perform to the best of my ability in the Ministry I hold and I have total faith with the Staff from the Health Dept starting from Secretary Level.

"As Minister I know my limits and it is public servants who will give me the best advice without any political interference from me.

"I am glad we have a good relationship as they know my past as a Union Leader and I trust my officers."

From his comments it appears that Mr Malabag has left all details on the BPP case up to the people who run and work in the Department of Health.

It is a pity that he does not have any medical background. He has the power to do so much but he lacks the medical knowledge to make any thoughtful decisions himself. It is all "Yes, Secretary!"

Now the Secretary is said to be a lawyer and lacks medical training. SO....who is going to suggest to the Secretary that he listens to the doctors and other health workers at the meeting on Monday?

Malabag has forgotten that "the people" are mainly illiterate and the "few elite minority on the social media" are the ones he should be listening to as they are educated and can understand the problems with Borneo PP.

Harry, Namah has been busy trying to get O'Neill arrested for the Paraka corruption scandal. He has also had to rally his supporters when the police tried to arrest him for a letter he wrote to the police.

Namah has also been attending court cases trying to get rid of the Australian immigration prisons on Manus.

Sam Basil has been trying to get the government to give the opposition their DSIP funds.

I don't know who the other three are.

PNG lacks a real Opposition.

O'Neill has been busy over in Bougainville "breaking spears" with Momis. I think a lot of the government politicians may be travelling the world or buying houses in Cairns.

The PNG Parliament is not working properly. So it is up to the thinking, educated, non-apathetic individuals who read and contribute to these Social Media sites, to become the actual opposition.

Dr Clement Malau, who used to run the Department of Health, and who now works for WHO in Fiji, has offered to come back and be part of a Commission of Enquiry. That may still happen.

O'Neill, I fear, is not DELEGATING! For whatever reason he is trying to do everything himself and not delegating authority to his ministers. Minister for Health, Malabag, should be the one speaking out in public but he is too quiet.

I had a suspicion that he doesn't understand ISO ratings and the need for them. I hope he is starting to read PNG Attitude. I read his Facebook page and he sounds as though, as a very popular ex-Trade Union leader, he still has a lot to learn if he is to be a good Minister for Health.

The present Secretary of Health, Pascoe Kase, is busy with the ban on buai in Moresby as he wants to stop mouth cancer.

They are all too busy to follow up on their previous acceptance of BPP to supply the drugs. The Post Courier is full of the facts that there have been many cases of faulty drugs, and people dying because of them, over the past few years. And they have evidently been supplied by BPP.

The rich know to buy their own drugs from the good pharmacies when they are sick. It is the poor people who are suffering. They say 70% are still illiterate.

Hopefully the doctors meeting on Monday will move the government to do something constructive about the present problem.

Barbara - Your tireless efforts in getting to the bottom of this mess is to be commended.

However it begs the question as to why the PNG parliamentary opposition hasn’t been able to (a) obtain the documents available and (b) table such documents in parliament and call for a commission of enquiry.

Is it too lazy or just indifferent to the needs of the general population, I wonder. Laissez faire seem to predominate it seems.

The one thing that bugs me is that the current health secretary is a lawyer by profession and should have detected the gross anomalies in the tendering process.

He is the principal advisor to the CSTB on any matters relating to health and sadly he is not up to the par. I think he should be sacked, along with his deputy secretaries and the so called chief medical officer in charge of the standards.

Mr Prime Minister, for once in your term in the office can you get one thing right and that is to call an urgent emergency NEC meeting and reverse the NEC decision.

You just cannot sit on this issue like you did for several high profile but non-life threatening cases.

21 January 2014- *PRESS STATEMENT FROM TIPNG* "PROVE US WRONG"
We thank Babaga Naime Secretary to the Central Supply & Tenders Board for his comments on the issue of ISO 9001 Accreditation not being required by Borneo Pacific Pharmaceutical Limited.

We do not see the comments as valid and challenge the CSTB and National Department of Health to reveal how they plan to prove our fears wrong.

As we see it either there are some very confused Public Officials in our system or there is a deliberate attempt being made to hide the truth.

The simple facts as we understand them are that a supply tender was invited from qualified bidders, the process was interrupted, changes were made to the requirements and a contract appears to have been inappropriately awarded to a disqualified bidder at a shockingly inflated price.

If we are wrong tell us where we are wrong.

CSTB: THE BOARD AFFIRMS THAT THE CONTRACT ADHERES TO PNG LAW AND SHOULD NOT BE QUESTIONED
We ask, how can it be legal to remove advertised pre-requisites for tendering during the process, particularly when one of these relates to the quality assurances required to qualify?

TI PNG believes in transparent processes and promotes openness, honesty and accountability in both public and private dealings. With great respect to the Central Supply & Tenders Board and PNG Laws, we also value the lives of our fellow Papua New Guineans enough to support the questioning of the validity of the recent contract.

CSTB: BORNEO PACIFIC DID NOT NEED ISO9001 ACCREDITATION BECAUSE IT WAS NOT A MANUFACTURER OF MEDICAL SUPPLIES BUT JUST THE SUPPLIER.

If ISO9001 was an advertised requirement then in our opinion it is necessary that even non-manufacturing suppliers must have it, ISO Certification in Papua New Guinea is not limited to Drug Manufacturers or other product manufacturers alone.

ISO9001 is a world standard of “Quality Assurance”. Among other things, it is primarily intended to provide a customer with an independently assessed level of “assurance” that their vendor has the appropriate internal operational processes in place to “ensure” that the product or service being provided meets that customer’s requirements.

CSTB: …TWO OTHER BIDDERS DID NOT HAVE THE LOCAL EXPERIENCE AND WERE NOT REGISTERED WITH EITHER THE INVESTMENT PROMOTION AUTHORITY OR THE PNG PHARMACEUTICAL BOARD, WHICH WERE STATED PRE-REQUISITES.

When did local experience become a requirement? TI PNG understands that the contract was open to tenders from qualified bidders to source and supply medical kits. We understood this to be a “supply” contract which follows a drug listing provided by the National Department of Health, and NOT a distribution contract.

Therefore, local experience is not relevant as far as we can establish a requirement.

On the other hand, TI PNG is aware that one of the unsuccessful tenders did satisfy the requirements stated above.

They had local experience, were registered with IPA and the Pharmaceutical Board, were ISO Accredited and ultimately had the lowest tender, which was almost K20 million less than the tender that won the contract.

We are still surprised that even they, who met all the requirements at an apparently more reasonable price were still unsuccessful.

TIPNG now urges the CSTB and National Department of Health to explain in FULL what happened with this extraordinary award.

ALSO - information from the expert -
Deborah R. Telek Quality Assurance is my bread & butter so let me clear the air on some things. There is a misconception in GOVERNMENT about what ISO9001 refers to.

There are various "standards" applied in a whole range of industries & they are categorised numerically. Some of the more popular/ commonly known are:

Quality Management is simply a standard which aims to hold the Management of an organisation or company ultimately accountable for the way that the company is run, regardless of the product which is being manufactured or the service that is being provided.

In order to qualify for an ISO9001 rating, the company has to prove to an approved ISO auditor that they have in place policies, systems and procedures to capture customer, employee and management feedback in order to improve their business & ultimately their product or service. These relate to the:

In the case of Borneo Pharmaceuticals the service being provided to us is "the procurement of medical drugs on behalf of the Government of Papua New Guinea."

An ISO9001 accreditation would ensure that an independent external auditor is periodically looking at HOW they source the medicines, HOW they shortlist the drug manufacturing companies and that the criteria is regularly discussed with GoPNG's NDoH, WHETHER or not they are providing important feedback to their clients IF AND WHEN problems are encountered, WHAT mitigation measures are in place to ensure that problems do not occur or are less frequent, HOW they monitor progress, WHETHER their key employees & management KNOW their jobs like the back of their hands, and HOW they track progress on key milestones and reports.

The external auditor would look at the contract between GoPNG and Borneo and be able to make a judgement call within 6 months - 12 months about whether or not Borneo is being a good (i.e. QUALITY) service provider.

By removing the qualification of an ISO9001 accreditation, the Government of Papua New Guinea is simply saying, "We trust that they will do the right thing and we don't need to know HOW they do it as long as we see something happening."

Dear GoPNG, for your information, this is NOT how modern businesses are run and this Tender was a business decision on behalf of the people of this nation. We pay Borneo; Borneo provides a service. If we have the means to make the service provision more transparent/ accountable then we should enforce it, not remove it.

ALSO -

Today’s Post Courier Headline just confirms what everyone already knows that the country’s Health Department and Health facilities are overflowing with Sub-Standard Drugs! Guess who has been the Exclusive “in house” drug procurement company used by NDoH since 1996?? Yes, you got it, Borneo Pacific Pharmaceuticals!!!

Here is a good letter from The National today ....I AM not impressed by the opposing remarks of the Central Supply and Tenders Board (CSTB) chairman in defence of its recommendation to the NEC to award the purchasing and distribution of medicinal drugs to Borneo Pharmaceuticals.
Allow me to explain the ISO 9001, which he may have limited knowledge of, resulting in the unexpected withdrawal of AusAID’s funding for medicinal drug distribution in PNG.
The ISO 9001 is a world-renowned quality management system that can be used by any organisation regardless of size, field of activity and products.
Its standards specify requirements for a quality management system where an organisation needs to demonstrate the ability to consistently provide products that meet customer needs applicable to statutory requirements, and aim to enhance customer satisfaction through the effective application of the system.
Thus, having accredited the ISO 9001 gives confidence to end users, supplies, donors, individuals or any organisations linked to the business, including the public at large.
The certification gives confidence that the business’ product or service is of quality.
It is therefore necessary that Borneo Pharmaceuticals’ drug purchasing and distribution processes be ISO 9001 certified as compliant to internationally accepted practices.
Only then will everyone be assured that drugs are of high quality.
It would also mean that their procedures from importing, storage to distribution are audited and conform to ISO standards as well as our own NISIT and ICCC standards, if we even have those.
If Borneo Pharmaceuticals is ISO 9001 compliant, it is also likely that it will be audited regularly to ensure that its suppliers and distributors must also be compliant.
This is a an international quality management system that promotes and safeguards product quality standard over fast-growing, low-quality, cheap products and services that are currently flooding the market everywhere, especially in developing countries such as PNG.
We often talk about getting rid of fake, low-quality, sub-standard products, but we do not actually do it because we do not see the importance of standards.
For some unknown reasons, our standards organisations (NISIT and ICCC) are very quiet about all this.
The accreditation and certification of business is very significant, especially in European Union countries, the United States, Australia and New Zealand.
The world has changed much lately in the way businesses are conducting their operations, especially in Asia, where profit is prioritised over quality.
AusAID, is helping us improve our health care system and cannot compromise quality. The repercussions of such decisions can be damaging to the health of our population.
Borneo Pharmaceuticals, without the ISO 9001 certification, will be a concern for all-quality minded people.